Human rights include the right to life and liberty, the right to be protected from slavery and oppression, the right to freedom of thought and expression, the right to work and education, the right to be free from violence and discrimination, and many more. Liberty includes the right to control one's health and body, such as sex and reproduction; and freedom from intervention, such as freedom from torture, unauthorised treatment and experimentation.

The health of us as humans and of the people we care about is a daily concern. The right to health for all means that everyone has access to the health and financial services they need, where and when they need them, without financial adversity. Everyone has the right to privacy and the right to be treated with respect and dignity. For this reason, the World Health Organization (WHO) announced the theme of 2024 World Health Day “My Health, My Rights.”

Since the WHO’s inception, people around the world have used World Health Day to highlight health issues and access to healthcare. The WHO prepares a different theme for this day every year and discusses this theme in schools, conferences, workshops, and forums. The purpose of this day is to raise awareness about the health problems of the poor and less fortunate around the world and to remind us to be thankful, eat healthy and take better care of ourselves. "To benefit from the highest standards of health is the fundamental right of all people, regardless of race, religion, belief, economic and social situation." The right to health has always been at the heart of the WHO's identity and mission.

Health is a fundamental and constitutional right

Article 15(a) of the Constitution of the People‌‌‍’s Republic of Bangladesh recognises healthcare as a fundamental right for all citizens and instructs the government to implement this right. Article 18(1) stipulates that improving food standards and public health are fundamental responsibilities of the government. It is increasingly recognised that a healthy population is a key driver of economic growth and prosperity. Therefore, health should be the priority of the government of Bangladesh.

What is the basis for our important role in health to right?

Health is a human right. This is a fundamental right to life. But why? Because good health from birth increases our chances of survival. Poor health can keep us from going to school or work, fulfilling family responsibilities, or participating in society. Likewise, we are willing to make many sacrifices if it means ensuring the long-term health of ourselves and our families.

On the other hand, health is not only about preventing preventable diseases, but most importantly, enabling us to acquire and contribute the necessary knowledge, skills and behaviours to live a suitable and useful life and contribute to personal interests, for the welfare of the society and country. Simply put, when we talk about happiness we usually think of health. Thus, we believe that health is our most valuable and important asset, regardless of our age, gender, health and race.

Therefore, health is our common responsibility. It is not possible for the state to achieve all this alone. People have the right and responsibility to take action, individually and collectively, to protect and improve the health of themselves, their families, and their communities. We must exercise this right and participate responsibly.

COVID-19 pandemic and human rights to health

COVID-19 has had a massive impact around the world. Surprisingly, even developed countries such as the United States and the United Kingdom suffered greatly during the pandemic despite having good healthcare systems. On the other hand, many underdeveloped countries like Bangladesh have inadequate health care systems, but it has suffered less than that problem. Unfortunately, there is no magic. Instead, reality tells a different story. The pandemic has exposed the incompetence of Bangladesh's healthcare system and many forms of corruption, such as personal protective equipment fraud, the Regent Hospital fraud, and the JKG scandal, etc.

Bangladesh's healthcare system lacks reliability, accountability, and transparency and has proven unable to provide adequate healthcare to the population. It focuses on medical facilities in urban areas, ensuring the distribution of health services and freeing rural areas from medical resources. Moreover, COVID-19 has also revealed many negative aspects of healthcare, which can be summarised in three points – poor management and greater consumption of money, inadequate medical facilities, and poor public health communication.

The Covid-19 pandemic does two things. Firstly, it affects efforts to improve health outcomes and healthcare disparities, disrupts health services, increases unemployment, and gender-based violence, etc. Secondly, it shows the need for law enforcement in the interests of human health and the weakness of human society in its absence. The lessons learned through the healthcare crisis during the COVID-19 pandemic in Bangladesh should be considered as a step towards rethinking the right to health as per the constitution.

SDGs and specific human rights

Health is a human right in itself and an important way to realise other human rights. It is one of the many aspects of human health that are necessary for the enjoyment of human rights. Health also plays an important role in helping people participate in other activities that improve their health. Bangladesh's constitution promises to address inequalities in access to healthcare in rural areas, and the country joins the international community in committing to achieving global healthcare by 2030 according to the Sustainable Development Goals (SDGs).

SDG-3 denotes making life healthy and promoting health for all people every day. Its goals include reducing maternal mortality, ending preventable child mortality, ending or reducing AIDS and other diseases, universal healthcare, easy access to essential medicines, sexual and reproductive health services, vaccine research and access to medicines. These fundamental human rights cannot be achieved without Universal Health Coverage (UHC), which ensures that everyone receives the health care they need without falling into financial poverty.

Recommendations for recognising the right to health in Bangladesh

We should do —

To ensure that policies, strategies, operational plans, and other services of the health ministry comply with the principles of equity, equality, efficient, and effective health and nutrition services.

To develop, implement and disseminate health and nutrition policies regarding these services.

Equal access to healthcare should be ensured regardless of gender, including for disabled and vulnerable people.

To provide sustainable financing for equitable access to healthcare for the people along with appropriate allocation and efficient utilisation, and make progress towards UHC.

To ensure a high-quality skill-mix health workforce available to all public and private health facilities.

Introducing incentives to provide healthcare in remote areas.

Elevating the standards of service of community clinics.

To ensure ANC, delivery and PNC for better maternal and child health.

Undertaking programmes to prevent people from communicable and other diseases.

Building and maintaining trust in our own healthcare system.

Introducing a proper well-organised NID-based referral system, and keeping an electronic medical record (EMR).

Improvement in regulation for the private sector.

The human right to health is that it is difficult to assign the duties that correspond to these rights.

And, promoting health as a human right in Bangladesh.

In conclusion, health is more than healthcare. Health and human rights are interrelated. The right to health relates to and depends on the fulfilment of other human rights, including the rights to life, food, shelter, work, education, privacy, access to information, freedom from torture, and the rights to freedom of association and assembly and sports. Recognition and understanding of health as a human right requires health services and evidence-based practices, including implementation and evaluation. Availability, accessibility, acceptability, and quality of services require that health services be researched and medically appropriate and of the best quality.

Doctors and medical professionals play an important role but are not the primary responsibility in providing all healthcare services. It is a responsibility shared by equitable and universal access to adequate health care is a national moral responsibility.

Human rights violations or lack of attention can have serious health consequences. Therefore, increasing coordination among different departments of the public health system with determinants of health and improving regulation of the health sector are imperative. Access to the best possible healthcare is a basic human right.

The writer is a health economist and paediatric urologist. He is the secretary general of the Bangladesh Health Economist Forum.